A patient is very short of breath. Which finding should cause the nurse to be concerned that the shortness of breath might be due to heart failure?

An echocardiogram that reflected increased right ventricular wall thickening

A left ventricular ejection fraction (VEF) of 50%

A B-type natriuretic peptide (BNP) of 300 pg/mL

A serum sodium of 135

Answer and Explanation

The Correct Answer is B

A. An increase in O2 saturation to greater than 90%: An increase in oxygen saturation is typically a positive sign and does not indicate worsening heart failure.

B. The onset of atrial fibrillation: The development of atrial fibrillation in a patient with heart failure is a sign of worsening heart failure, as it indicates increased atrial pressure and the potential for further hemodynamic compromise.

C. Louder S1 and S2 heart sounds: Louder heart sounds do not specifically indicate worsening heart failure. They may vary based on other factors such as body habitus or the position of the patient.

D. A decrease in heart rate to 66 bpm: A heart rate of 66 bpm is within the normal range and does not suggest worsening heart failure.

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Correct Answer is ["15.94"]

Explanation

Convert the ordered dose to mcg/min:

10 mcg/kg/min × 85 kg = 850 mcg/min

Convert the available dose to mcg/mL:

800 mg = 800,000 mcg in 250 mL

Concentration = 800,000 mcg ÷ 250 mL

= 3200 mcg/mL

Calculate the infusion rate:

Infusion rate (mL/hour) = [Desireddose(mcg/min) ÷Concentration(mcg/mL)] ×60 min/hour

Infusion rate = (850 mcg/min ÷ 3200 mcg/mL) × 60 min/hour

= 15.94 mL/hour

The IV pump should be set to infuse at approximately 15.94 mL/hour to deliver the ordered dose of dopamine at 10 mcg/kg/min for a patient weighing 85 kg. This ensures the appropriate therapeutic effect.

A. Monitoring of results of liver function testing B. Assessment for signs and symptoms of jaundice C. Measurement of abdominal girth and body weight D. Assessment for variceal bleeding

Correct Answer is C

Explanation

A. Monitoring of results of liver function testing: While important, monitoring liver function tests is a routine assessment rather than a prioritized one compared to assessing for complications like ascites.

B. Assessment for signs and symptoms of jaundice: Jaundice is a common finding in cirrhosis but does not necessarily indicate an acute complication.

C. Measurement of abdominal girth and body weight: In advanced cirrhosis, monitoring for ascites and fluid retention is critical as these indicate worsening disease and potential complications.

D. Assessment for variceal bleeding: Incorrect. While important, the priority in routine assessment is monitoring for ascites and fluid overload, which can be managed more readily.

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A patient is very short of breath. Which finding should cause the nurse to be concerned that the shortness of breath might be due to heart failure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The physician orders dopamine at 10 mcg/kg/min. The pharmacy provides dopamine 800mg in 250 ml of D5W. What is the hourly IV pump rate? The patient weighs 85 kilograms. Order: Dopamine at 10 mcg/kg/min Available: Dopamine 800 mg in 250 mL D5W Patient weight: 85 kg

Correct Answer is ["15.94"]

Explanation

. A nurse is caring for a client who has been admitted for the treatment of advanced cirrhosis. What assessment should the nurse prioritize in this client's plan of care?

Correct Answer is C

Explanation

The nurse is assessing a patient for heart failure (HF). Which early findings would indicate decreased cardiac output and a potential for fluid overload from heart failure?

Which of the following signs/symptoms would not be seen in a patient with cirrhosis?

A nurse is caring for a client on mechanical ventilation and finds the client agitated and thrashing about. What action by the nurse is most appropriate?

A patient with cirrhosis is becoming lethargic and confused. Which of the following labs does the nurse expect the HCP (health care provider) to order?

A triage nurse in the emergency department is assessing a client who presented with reports of general malaise. Assessment reveals the presence of jaundice and increased abdominal girth. What assessment question best addresses the possible etiology of this client's presentation?

The patient who has just undergone a CABG says to the nurse "I am cured of coronary artery disease" What is the nurse's best response to this statement?

The nurse assesses the port balloon on the ETT (endotracheal tube) of an intubated patient and is unsure if the balloon is properly inflated. What is the nurse's best action?

A nurse reviews the following ABG result: pH 7.37 PaO2 84 PaCO2 54 Bicarbonate: 31 Saturation: 95% What is the interpretation of this ABG?